NPI | 1366993297 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA G40754) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA G40754) |
2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA G40754) | |
Enumeration Date | 2016-10-15 |
Last Update Date | 2016-10-15 |